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Narrowband UV-B (NBUVB) phototherapy is the mainstay of vitiligo treatment, but hyperpigmentation is one of the limitations. Meanwhile, topical tretinoin is effective against pigmentary disorders.To determine whether tretinoin 0.05% cream would prevent hyperpigmentation when patients with facial vitiligo underwent phototherapy.A randomized, controlled, split-face trial was conducted. Adult patients with stable, non-segmental facial vitiligo were enrolled. The left/right sides of the face were randomly allocated to receive either topical tretinoin 0.05% cream or moisturizer twice daily. The entire face was subjected to NBUVB phototherapy twice weekly for 12 weeks. The degree of hyperpigmentation was assessed as the delta L* (brightness) value of the darkest spot in each side of the face at baseline and every 4 weeks. The degree of repigmentation was assessed.Twenty-five patients were enrolled; 21 completed the study. The delta L* value was significantly different between the two groups: -0.5% in the tretinoin group and -8.7% in the control group at 12 weeks (Tretinoin 0.05% cream prevented hyperpigmentation during NBUVB phototherapy in patients with facial vitiligo, and did not compromise the overall treatment response.ClinicalTrials.gov NCT03933774.

Nodulocystic acne is prone to scarring and difficult to treat with treatments other than oral isotretinoin. The aim of this article is to discuss the role of a single session of a fractional carbon dioxide (CO2) laser combined with a topical treatment with a tretinoin and antibiotic gel for a month as a successful treatment to improve nodulocystic acne and chronic microcystic acne. Two cases were involved: the first with nodulocystic acne lesions that persisted after oral retinoids and the second with chronic microcystic acne resistant to topical treatments. After only one session of treatment with the CO2 laser and the topical treatment, a complete healing of the nodulocystic acne lesions was observed with minimal secondary effects. The microcystic acne showed great improvement. No other topical or oral treatment was needed. This treatment could be a safe and effective treatment for nodulocystic acne lesions and microcystic acne when other treatments fail. More studies should be performed to confirm our results.

Fibroelastolytic papulosis (FEP) is an acquired elastic tissue disorder that presents as white-to-yellow papules and plaques usually occurring on the neck. Although the lesions are often asymptomatic, their appearance may be distressing to patients. FEP has been treated with topical tretinoin in one case report (1). Other reports have not mentioned treatment for this rare disorder (1–6). We present a case of FEP successfully treated with a fractionated carbon dioxide (CO2) laser.

We have investigated the effects of short-contact topical application of tretinoin using 16 male db/db mice by creating two full-thickness wounds on the skin of the back. A 0.1% tretinoin aqueous gel was applied to one wound for five minutes daily for five successive days while only aqueous gel was applied to the other (control). The mean (SD) percentage surface area unhealed before and after treatment were 0.88 (0.3) and 0.64 (0.15). In tretinoin-treated mice and non-treated mice (controls), the mean (SD) thicknesses of granulation were 1.383 (697) micro m and 683 (413) micro m, the density of capillary vessels in granulation was 12.2 (5.5)% and 5.7 (3.9)%, respectively. Differences between the two groups were significant for each variable. Wound healing was accelerated with short-contact topical application of tretinoin in db/db mice.

Some of the clinical sequelae of cutaneous photodamage include wrinkling, pigmentary changes, roughness, laxity and telangiectasia, which can result in the aging of the appearance. This in turn can have a negative impact on certain aspects of quality of life including: (1) social interactions, most commonly manifesting as uneasiness and anxiety during interpersonal interactions; (2) occupational functioning, in that an attractive and youthful appearance may be associated with better employment opportunities; and (3) the psychological state of the individual, resulting in decreased self-esteem and an adjustment disorder. Among some individuals, concerns about an aging appearance can culminate in an excessive preoccupation with dieting, exercise and thinness. Studies have shown that a reduction in the cutaneous stigmata of photodamage with topical tretinoin is associated with an improvement in these dimensions of quality of life. The possible geographic and sociocultural differences in the impact of photoda...

Photodamaged skin shows striking alterations in both epidermis and dermis. Epidermal dysplasia is a frequent finding even in the absence of clinical changes. Solar elastotic degenerative change app...

Five male patients, aged 52 to 61 years, with severely photodamaged forearm skin received 0.05% tretinoin cream twice daily for 1 month. The following procedures were done before and after treatment: (1) 3-mm punch biopsies for histochemical evaluation, (2) sticky slides to determine the degree of melanization of corneocytes, (3) detergent scrubs for corneocyte sizing and morphological evaluation, and (4) Silflo replicas for surface topography visualization. A modest improvement in surface texture was observed. By contrast, histological changes were striking. Epidermal abnormalities were largely corrected. Atypia and dysplasia were eliminated, accompanied by acanthosis restoration of polarity and a thinned horny layer. Dermal changes were insignificant. Glyphic patterns were shown to have redeveloped in replicas of the skin surface. Melanin granules within corneocytes decreased sharply; this was associated with modest bleaching of pigmented spots. Thus it was demonstrated that the typical effects of treti...

Conflicting reports have described topical tretinoin as either enhancing or inhibiting ultraviolet radiation-induced tumorigenesis in albino hairless mice. A number of reviews have addressed the issue, with two assessing the relevance of the hairless mouse model. The large body of literature that describes the antineoplastic activity of tretinoin combined with the almost 25 years' use on sun-exposed human facial skin without evidence for carcinogenicity argue for a further analysis of the paradox. In this review, several new findings call into question the appropriateness of the model.

Chloracne is a rare but serious manifestation of systemic poisoning with polyhalogenated aromatic chemicals. It is alrqost invariably due to occupational exposure, often as a result of an industrial accident. Comedones, sometimes with inflammatory lesions, are the principal skin signs and most accurately reflect systemic toxicity. Hepatotoxicity, neuropathy and lipid abnormalities also occur. The skin lesions are resistant to most conventional acne therapies. Topical tretinoin may be of some benefit for comedones. Light cautery of comedones is successful and, although time consuming for the patient, many comedones can be treated in a 15 minute session. Limited experience with oral isotretinoin suggests that it is not very effective in chloracne. An outbreak of chloracne requires detailed investigation of the industrial process responsible to eliminate further exposure. The prognosis for mild cases of chloracne is good provided contact with the chloracnegen ceases.

Flat warts, mainly caused by human papillomavirus types 3 and 10, have a high rate of spontaneous remission. Those warts that do not disappear by themselves can be very difficult to treat. In our study we compared the efficacy of topical tretinoin, topical interferon beta and the combination of both substances in the treatment of flat warts. The combination of both substances proved to be considerably more effective than either alone.

Nineteen adult women with stubborn papulo-pustular rosacea received low-strength 0.025% tretinoin cream (Retin-A, Johnson & Johnson) for 6 to 12 months. This dosage was surprisingly well tolerated, with only one dropout after 2 weeks. Although the response was slow, half the subjects achieved nearly complete clearing, which persisted for 6 months after stopping tretinoin. An unexpected and unprecedented finding was lessening of erythema and partial to complete disappearance of telangiectasia. Tretinoin has not previously been tried in rosacea, probably because of the prevailing notion that the main or sole action is comedolytic; comedones of course are lacking in rosacea. On the other hand, photodamage is an invariable feature of the disease and tretinoin has been shown to improve actinically damaged facial skin. Moreover, the ability of tretinoin to suppress inflammation may also be an ameliorating factor.

INTRODUCTION Topical tretinoin (Retin-A), although currently recommended for the treatment of acne, has also been reported to be of benefit in a wide range of skin diseases including plane warts, i...